A client being treated for compartment syndrome has been hospitalized for 4 days. He has no history
of psychiatric disorder but is described by his family as being "a difficult person who finds fault
with others.".
From the day of admission he has verbally abused the nurses for their inability to
provide care that keeps him pain free and comfortable. The most likely explanation lies in
a. poor child-rearing that did not teach respect for others.
b. automatic thinking leading to cognitive distortion.
c. a personality style that externalizes problems.
d. delusions that others wish to harm him.
C
Clients whose personality style causes them to externalize blame see the source of their discomfort
and anxiety as being outside themselves. They displace anger and are unable to take responsibility
for self-soothing. On the basis of family input, the other options are less likely to have a bearing on
his behavior.
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The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry recognizes the need for added instruction when the patient says:
a. "I can ambulate in the hallway with this gadget on." b. "I always take off the telemetry device when I shower." c. "My EKG is being watched by one of the nurses in CCU on the home unit." d. "I am able to sleep just fine with this device on."
A woman who is about to be discharged following a mastectomy states, "I am so afraid of what my husband will think of me." What is the most appropriate response for the nurse to make?
A) "I am sure he will be fine, but it may take some time." B) "Have you asked him about how he feels?" C) "Would you like me to help you talk to him about it?" D) "Do you have any friends who have had mastectomies?"
A client's chest tube is accidentally dislodged. What action by the nurse is best?
a. No action is necessary because the area will reseal itself. b. Cover the insertion site with a sterile gauze and tape three sides. c. Obtain a suture kit and prepare for the physician to suture the site. d. Cover the area with an occlusive dressing.
The client has been diagnosed with heart failure. The nurse is asked if the client's symptoms are more likely right or left heart failure. Which of the following symptoms would indicate left-sided heart failure?
1. Respiration of 36 per minute 2. Right upper quadrant pain 3. Dependent edema 4. Anasarca